1
|
Kato M, Ozaki E, Matsui D, Nakano W, Nakano S, Ono S, Kito K, Koyama T. Locomotive syndrome and depressive symptoms: A cross-sectional study in middle-aged women. Mod Rheumatol 2024; 34:858-863. [PMID: 37801366 DOI: 10.1093/mr/road096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE Evidence for an association between locomotive syndrome (LS) and depression is lacking in middle-aged women. This study aimed to investigate the relationship between LS severity and depressive symptoms in community-dwelling middle-aged women. METHODS This cross-sectional study included 1520 middle-aged women (mean age 52 ± 6 years). LS severity was evaluated using the 25-question Geriatric Locomotive Function Scale questionnaire and motor function test. Depressive symptoms were assessed using the Zung self-rating depression scale. Multiple logistic regression analyses were performed to determine the association between depressive symptoms and LS severity, adjusting for potential confounding factors. RESULTS LS severity, as evaluated through both questionnaires and motor function tests, was significantly associated with depressive symptoms (self-rating depression scale ≥ 40 points) in middle-aged women. The relationship between LS and depressive symptoms was only significant when assessed through the 25-question Geriatric Locomotive Function Scale questionnaire rather than the motor function tests. Additionally, a stepwise association was observed between pain severity, as assessed by the 25-question Geriatric Locomotive Function Scale, and the prevalence of depressive symptoms. CONCLUSIONS LS severity is significantly associated with depressive symptoms in community-dwelling middle-aged women, suggesting the need for additional mental status assessment in participants with LS and concurrent pain.
Collapse
Affiliation(s)
- Michitaka Kato
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Wataru Nakano
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoko Nakano
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sintaro Ono
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Kazuya Kito
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
2
|
Choi HR, Chang Y, Park J, Cho Y, Kim C, Kwon MJ, Kang J, Kwon R, Lim GY, Ahn J, Kim KH, Kim H, Hong YS, Park J, Zhao D, Cho J, Guallar E, Park HY, Ryu S. Early-onset vasomotor symptoms and development of depressive symptoms among premenopausal women. J Affect Disord 2024; 354:376-384. [PMID: 38503358 DOI: 10.1016/j.jad.2024.03.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND We investigated the association between vasomotor symptoms (VMSs) and the onset of depressive symptoms among premenopausal women. METHODS This cross-sectional study included 4376 premenopausal women aged 42-52 years, and the cohort study included 2832 women without clinically relevant depressive symptoms at baseline. VMSs included the symptoms of hot flashes and night sweats. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale; a score of ≥16 was considered to define clinically relevant depressive symptoms. RESULTS Premenopausal Women with VMSs at baseline exhibited a higher prevalence of depressive symptoms compared with women without VMSs at baseline (multivariable-adjusted prevalence ratio 1.76, 95 % confidence interval [CI] 1.47-2.11). Among the 2832 women followed up (median, 6.1 years), 406 developed clinically relevant depressive symptoms. Women with versus without VMSs had a significantly higher risk of developing clinically relevant depressive symptoms (multivariable-adjusted hazard ratio, 1.72; 95 % CI 1.39-2.14). VMS severity exhibited a dose-response relationship with depressive symptoms (P for trend <0.05). LIMITATIONS Self-reported questionnaires were only used to obtain VMSs and depressive symptoms, which could have led to misclassification. We also could not directly measure sex hormone levels. CONCLUSIONS Even in the premenopausal stage, women who experience hot flashes or night sweats have an increased risk of present and developed clinically relevant depressive symptoms. It is important to conduct mental health screenings and provide appropriate support to middle-aged women who experience early-onset VMSs.
Collapse
Affiliation(s)
- Hye Rin Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea.
| | - Jungeun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea
| | - Yoosun Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea
| | - Chanmin Kim
- Department of Statistics, Sungkyunkwan University, Seoul 03063, Republic of Korea
| | - Min-Jung Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea
| | - Jeonggyu Kang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea
| | - Ria Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Ga-Young Lim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Jiin Ahn
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea
| | - Kye-Hyun Kim
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Yun Soo Hong
- Departments of Epidemiology and Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; McKusick-Nathans Institute, Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Jihwan Park
- Departments of Epidemiology and Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Di Zhao
- Departments of Epidemiology and Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Juhee Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea; Departments of Epidemiology and Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Hyun-Young Park
- Department of Precision Medicine, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju 28159, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea.
| |
Collapse
|
3
|
Gavralas K, Brown L, Bryant C. Longitudinal relationships between self-compassion and depressive symptoms in midlife women. Climacteric 2023; 26:619-624. [PMID: 37839438 DOI: 10.1080/13697137.2023.2256651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/18/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Women in midlife face a range of biopsychosocial stressors that increase the risk of depression, with potential negative consequences in older adulthood. Lower self-compassion is known to predict subsequent depressive symptoms, but little is known about whether depressive symptoms predict subsequent levels of self-compassion. This study examined the longitudinal and reciprocal relationships between self-compassion and depressive symptoms over a 5-year period in midlife. METHOD This longitudinal study used data from 272 women aged 40-60 years at baseline. Cross-lagged panel analysis was used to investigate reciprocal relationships between depressive symptoms and self-compassion at baseline and 5-year follow-up. RESULTS After controlling for autoregressive effects, self-compassion at baseline explained 4% of unique variance in depressive symptoms 5 years later. Baseline depressive symptoms also predicted subsequent levels of self-compassion, with 2% of unique variance explained. CONCLUSION This is the first study to report a bidirectional longitudinal relationship between self-compassion and depressive symptoms. Midlife women may experience a negative cycle whereby low self-compassion and depressive symptoms reinforce each other through midlife and into older adulthood. Clinical trials examining self-compassion interventions in midlife are indicated.
Collapse
Affiliation(s)
- K Gavralas
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - L Brown
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, VIC, Australia
- Healthscope Hospitals, Melbourne, VIC, Australia
| | - C Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
4
|
Iqbal AZ, Wu SK, Zailani H, Chiu WC, Liu WC, Su KP, Lee SD. Effects of Omega-3 Polyunsaturated Fatty Acids Intake on Vasomotor Symptoms, Sleep Quality and Depression in Postmenopausal Women: A Systematic Review. Nutrients 2023; 15:4231. [PMID: 37836515 PMCID: PMC10574492 DOI: 10.3390/nu15194231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The menopausal transition is often accompanied with distressing manifestations, such as vasomotor symptoms, sleep disruptions, and depressive syndrome. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have emerged as a potential intervention to alleviate these symptoms. This review aimed to comprehensively assess the impact of n-3 PUFAs supplementation on vasomotor symptoms, sleep quality, and depression among postmenopausal women. We conducted a systematic literature search of randomized controlled trials across the Cochrane Library, Web of Science, PubMed, CINAHL, EMBASE, and SCOPUS databases from inception to August 2023. Among the initial pool of 163 identified studies, nine studies met the inclusion criteria and were incorporated into this systematic review. Notably, four studies detected potential benefits of n-3 PUFAs in improving hot flashes and night sweats. On the contrary, sleep quality outcomes displayed heterogeneity across the studies. Incorporating diverse scales, such as the Hamilton Depression Rating Scale-21, the Patient Health Questionnaire depression scale, and Generalized Anxiety Disorder-7 for depression outcomes, we found inconclusive evidence of n-3 PUFA's impact on depression. Overall, the combined analysis of these studies did not provide substantial evidence to support the efficacy of n-3 PUFAs in improving vasomotor symptoms, sleep quality, and depression. Further well-designed randomized clinical trials with larger participant groups are crucial to validate and generalize these results. Review Registration: PROSPERO registration no: CRD42023421922.
Collapse
Affiliation(s)
- Ayesha Zafar Iqbal
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan; (A.Z.I.); (S.-K.W.); (H.Z.)
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Suet-Kei Wu
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan; (A.Z.I.); (S.-K.W.); (H.Z.)
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Halliru Zailani
- Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan; (A.Z.I.); (S.-K.W.); (H.Z.)
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
| | - Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei 106, Taiwan;
- School of Medicine, Fu Jen Catholic University, Taipei 242, Taiwan
| | - Wen-Chun Liu
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan;
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Shin-Da Lee
- Ph.D. Program in Healthcare Science, Department of Physical Therapy, China Medical University, Taichung 404, Taiwan
| |
Collapse
|
5
|
Stawski RS, Cichy KE, Witzel DD, Schuyler AC, Nichols MJ. Daily Stress Processes as Potential Intervention Targets to Reduce Gender Differences and Improve Mental Health Outcomes in Mid- and Later Life. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:876-886. [PMID: 36227398 PMCID: PMC9558008 DOI: 10.1007/s11121-022-01444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/26/2022]
Abstract
The current study examines daily stress processes as risk factors for comprised mental health in midlife and later life, specifically for gender differences in depression risk. Using data from the Midlife in the United States (MIDUS) study and the National Study of Daily Experiences (NSDE), we examine (1) gender differences in depression; (2) the prospective effects of differential exposure and affective responses on 10-year depression status; (3) gender differences in daily stress-depression links. Furthermore, we explore whether the protective factor of help-seeking behavior moderates the effects of daily stress on depression. Participants included 1289 (mage = 55; SD = 12; range = 34-83; 56% female) individuals who completed the second waves of MIDUS and the 8-day NSDE daily diary protocol and participated in the third wave of MIDUS approximately 10 years later. Respondents completed assessments of depression and their seeking assistance from a psychiatrist, mental health professional, counselor, or religious leader. Covariate-adjusted logistic regression analyses revealed increased odds of depression among women compared to men, but no significant gender difference after taking daily stress into account. Higher levels of stressor exposure, negative affect, and affective reactivity were associated with increased odds of depression for both men and women. Compared to those who did not engage in help-seeking behavior, those who did had significantly greater odds of depression, and there were asymmetric patterns of daily stress effects across groups. These findings highlight differential exposure, negative affect, and affective responses to daily stress as potentially accessible intervention targets for reducing stress in daily life and mitigating longer-term depression risk during mid- and later life.
Collapse
Affiliation(s)
- Robert S Stawski
- Institute of Public Health and Wellbeing, and School of Health and Social Care, University of Essex, Colchester, England, UK.
| | - Kelly E Cichy
- Human Development and Family Studies, School of Lifespan Development and Educational Sciences, Kent State University, Kent, OH, USA
| | - Dakota D Witzel
- Center for Healthy Aging, The Pennsylvania State University, State College, PA, USA
| | - Ashley C Schuyler
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Madeline J Nichols
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR, USA
| |
Collapse
|
6
|
van Loo HM, Beijers L, Wieling M, de Jong TR, Schoevers RA, Kendler KS. Prevalence of internalizing disorders, symptoms, and traits across age using advanced nonlinear models. Psychol Med 2023; 53:78-87. [PMID: 33849670 PMCID: PMC9874996 DOI: 10.1017/s0033291721001148] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/02/2021] [Accepted: 03/12/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Most epidemiological studies show a decrease of internalizing disorders at older ages, but it is unclear how the prevalence exactly changes with age, and whether there are different patterns for internalizing symptoms and traits, and for men and women. This study investigates the impact of age and sex on the point prevalence across different mood and anxiety disorders, internalizing symptoms, and neuroticism. METHODS We used cross-sectional data on 146 315 subjects, aged 18-80 years, from the Lifelines Cohort Study, a Dutch general population sample. Between 2012 and 2016, five current internalizing disorders - major depression, dysthymia, generalized anxiety disorder, social phobia, and panic disorder - were assessed according to DSM-IV criteria. Depressive symptoms, anxiety symptoms, neuroticism, and negative affect (NA) were also measured. Generalized additive models were used to identify nonlinear patterns across age, and to investigate sex differences. RESULTS The point prevalence of internalizing disorders generally increased between the ages of 18 and 30 years, stabilized between 30 and 50, and decreased after age 50. The patterns of internalizing symptoms and traits were different. NA and neuroticism gradually decreased after age 18. Women reported more internalizing disorders than men, but the relative difference remained stable across age (relative risk ~1.7). CONCLUSIONS The point prevalence of internalizing disorders was typically highest between age 30 and 50, but there were differences between the disorders, which could indicate differences in etiology. The relative gap between the sexes remained similar across age, suggesting that changes in sex hormones around the menopause do not significantly influence women's risk of internalizing disorders.
Collapse
Affiliation(s)
- Hanna M. van Loo
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lian Beijers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martijn Wieling
- Department of Information Science, University of Groningen, Groningen, The Netherlands
| | | | - Robert A. Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Groningen, The Netherlands
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
7
|
Lee S, Jeong S, Choi Y. Effects of Psychological Well-Being and Depression on Menopausal Symptoms in Middle-Aged South Korean Women and the Necessity of Exercise. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:6529393. [PMID: 36193400 PMCID: PMC9526568 DOI: 10.1155/2022/6529393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/20/2022] [Accepted: 07/18/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to provide basic data on the health by examining the effects of psychological well-being and depression on menopausal symptoms and the necessity of exercise in middle-aged women. This study is a cross-sectional study using a structured questionnaire. The respondent's consent was obtained prior to data collection, and the investigation period runs from November 1, 2021 to November 30, 2021. The final analysis included 150 as respondents to the study. The tool developed by Yang was used for psychological well-being, the Korean integrated CES-D tool was used for depression, and the Menopause Symptom Index was used for menopausal symptoms. The differences and levels of psychological well-being, depression, and menopausal symptoms according to demographic and sociological characteristics were analyzed using descriptive statistics, t-test, and ANOVA. The correlation between psychological well-being, depression, and menopausal symptoms was analyzed by Pearson's correlation, and the effect on menopausal symptoms was analyzed by multiple regression. Because of this study, significant results were found in marital status, religion, economic level, regular exercise, hobbies, personality, and subjective health in the difference in psychological well-being according to general characteristics. In depression, significant results were found in marital status, education level, monthly income, living status, regular exercise, hobbies, stress, personality, and subjective health status. Moreover, age, frequent exercise, hobby, and subjective health all had a significant impact on menopausal symptoms. According to the findings of the regression analysis, the factors influencing menopausal symptoms were, in that order, depression and psychological well-being. Among the factors that showed significant results for menopausal symptoms, exercise is recommended as a factor that can alleviate menopausal symptoms due to individual lifestyle changes, so it is expected to contribute to reducing menopausal symptoms and improving quality of life.
Collapse
Affiliation(s)
- Sungsim Lee
- Department of Nursing, Gangneung Yeongdong College, 357 Gongje-ro, Gangneung-si, Gangwon-do, Republic of Korea
| | - Sookyoung Jeong
- Department of Nursing, Saekyung College, 197 Hasong-ro, Yeongwol-eup, Yeongwol-gun, Gangwon-do, Republic of Korea
| | - Youngsoon Choi
- Department of Nursing, Kangwon National University, 346 Hwangjo-gil, Dogye-eup Samcheck-si, Gangwon-do 25949, Republic of Korea
| |
Collapse
|
8
|
Immigration transition and gastrointestinal symptoms during menopausal transition: midlife women in the US. Menopause 2022; 29:840-849. [DOI: 10.1097/gme.0000000000001989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Sialino LD, van Oostrom SH, Wijnhoven HAH, Picavet S, Verschuren WMM, Visser M, Schaap LA. Sex differences in mental health among older adults: investigating time trends and possible risk groups with regard to age, educational level and ethnicity. Aging Ment Health 2021; 25:2355-2364. [PMID: 33222516 DOI: 10.1080/13607863.2020.1847248] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Older women report lower mental health compared to men, yet little is known about the nature of this sex difference. Therefore, this study investigates time trends and possible risk groups. METHOD Data from the Doetinchem Cohort Study (DCS) and the Longitudinal Aging Study Amsterdam (LASA) were used. General mental health was assessed every 5 years, from 1995 to 1998 onwards (DCS, n = 1412, 20-year follow-up, baseline age 55-64 years). Depressive and anxiety symptoms were assessed for two birth cohorts, from 1992/1993 onwards (LASA cohort 1, n = 967, 24-year follow-up, age 55-65 years,) and 2002/2003 onwards (LASA cohort 2, n = 1002, 12-year follow-up, age 55-65 years) with follow-up measurements every 3-4 years. RESULTS Mixed model analyses showed that older women had a worse general mental health (-6.95; -8.36 to 5.53; range 0-100, ∼10% lower), more depressive symptoms (2.09; 1.53-2.63; range 0-60, ∼30% more) and more anxiety symptoms (0.86; 0.54-1.18; range 0-11, ∼30% more) compared to men. These sex differences remained stable until the age of 75 years, where after they decreased due to an accelerated decline in mental health for men compared to women. Sex differences and their course by age were consistent over successive birth cohorts, educational levels and ethnic groups (Caucasian vs. Turkish/Moroccan). CONCLUSION There is a consistent female disadvantage in mental health across different sociodemographic groups and over decennia (1992 vs. 2002) with no specific risk groups.
Collapse
Affiliation(s)
- Lena D Sialino
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Susan Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Julius Center for Health Services and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
10
|
Im EO, Yi JS, Chee W. Depressive symptoms and type II diabetes mellitus among midlife women. Menopause 2021; 28:650-659. [PMID: 33739318 DOI: 10.1097/gme.0000000000001759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES A decision tree analysis helps determine the complex characteristics of the groups that are closely connected with specific outcomes. Using a decision tree analysis, the purpose of this secondary analysis was to examine the associations of type II diabetes mellitus (DM) to depressive symptoms among midlife women from four major racial/ethnic groups in the US. while identifying the complex characteristics of the women that were closely linked to depressive symptoms. METHODS The data from two larger Internet survey studies were used for this analysis. The data from a total of 164 women (62 with type II diabetes and 102 without diabetes) were included. The data were collected using several instruments to measure background characteristics, health and menopausal status, and depressive symptoms (the Depression Index for Midlife Women). The data analysis was conducted using independent t tests, Mann-Whitney U tests, and decision tree analyses. RESULTS The total numbers and total severity scores of depressive symptoms were significantly higher in those with DM compared with those without DM (P < 0.05). There were significant differences in the total numbers and total severity scores of depressive symptoms by menopausal status and race/ethnicity (P < 0.05). DM was a significant factor that influenced the total severity scores of depressive symptoms among midlife women in peri- or postmenopausal stages who were born outside the US and among midlife women in their premenopausal stage (P < 0.05). CONCLUSIONS This study indicated several combined characteristics of midlife women at high risk for depressive symptoms that could provide directions for future interventions.
Collapse
Affiliation(s)
- Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA
| | | | | |
Collapse
|
11
|
The association of depressive symptoms to sleep-related symptoms during menopausal transition: racial/ethnic differences. ACTA ACUST UNITED AC 2020; 27:1315-1321. [PMID: 33110048 DOI: 10.1097/gme.0000000000001611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Despite an increasing number of studies reporting significant associations of depression to sleep problems in general, few studies have been conducted on racial/ethnic variations in the associations among midlife women in their menopausal transition. The purpose of this study was to determine the associations between depressive symptoms and sleep-related symptoms in a multiethnic group of midlife women while considering the women's race/ethnicity and menopausal status. METHODS This was a secondary analysis of the data from 1,054 midlife women in two larger studies. The depression index for midlife women and the sleep index for midlife women were used to measure sleep-related symptoms and depressive symptoms. Descriptive and inferential statistics including hierarchical multiple regression analyses were used for data analyses. RESULTS In the regression models by race/ethnicity, the total numbers (0.294 in non-Hispanic [NH] African Americans ≤ β ≤ 0.410 in NH Asians), and total severity scores (0.141 in Hispanic ≤ β ≤ 0.365 in NH Whites) of depressive symptoms were positively associated with the total severity of sleep-related symptoms (all P < 0.01). In the regression models by menopausal status, the total numbers (β = 0.106 in premenopausal and 0.443 in postmenopausal) and total severity scores (0.272 ≤ β ≤ 0.561) of depressive symptoms were positively associated with the total severity scores of sleep-related symptoms (all P < 0.05). CONCLUSIONS Further studies with diverse groups of midlife women using objective measurements and biomarkers are warranted to confirm the findings.
Collapse
|
12
|
Willi J, Ehlert U. Symptoms assessed in studies on perimenopausal depression: A narrative review. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 26:100559. [PMID: 33010665 DOI: 10.1016/j.srhc.2020.100559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 09/07/2020] [Accepted: 09/22/2020] [Indexed: 12/19/2022]
Abstract
The menopausal transition constitutes a phase of major biopsychosocial changes associated with an elevated risk for the development of depression. Perimenopausal depression is highly prevalent and usually characterized by core symptoms of a major depressive disorder combined with menopausal complaints such as vasomotor symptoms or other physical complaints. However, a distinct definition of the condition is lacking. The aim of this review is to portray the symptoms assessed in studies on perimenopausal depression in order to provide relevant information on the current understanding of this condition. A literature search was conducted using the databases PubMed, Cochrane Library, and PsycINFO. A total of 37 studies were included. Various assessment tools have been used to measure symptoms related to perimenopausal depression. Fifteen symptoms were identified. Depressed mood was assessed across all studies. Low energy or sleep disturbances, as acknowledged symptoms of a major depressive disorder, were surveyed in most studies. However, the assessment of menopausal complaints was rather heterogeneous. While vasomotor symptoms were often measured, other menopausal symptoms such as mood swings or pain were investigated less frequently. Sexual problems were only rarely assessed. Studies on perimenopausal depression regularly include the assessment of core symptoms of a major depressive disorder, but the assessment of menopausal complaints is inconsistent. While certain symptoms are commonly measured, others are not assessed. Such inconsistencies underline an ambiguous understanding of perimenopausal depression, which in turn affects the evaluation and treatment of the condition. Thus, the use of the existing guidelines on perimenopausal depression is recommended.
Collapse
Affiliation(s)
- Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
| |
Collapse
|
13
|
Ovariectomy Induces Microglial Cell Activation and Inflammatory Response in Rat Prefrontal Cortices to Accelerate the Chronic Unpredictable Stress-Mediated Anxiety and Depression. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3609758. [PMID: 32509856 PMCID: PMC7251427 DOI: 10.1155/2020/3609758] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/04/2020] [Indexed: 01/21/2023]
Abstract
Perimenopausal women are associated with increased risks of depression and anxiety, which may be potentially related to the lack of ovarian hormone with antidepression activity in the body. However, the precise mechanism remains unclear so far. This study first adopted the Sprague-Dawley (SD) female rats to construct the ovariectomy (OVX) combined with a chronic unpredictable stress (CUS) model. Then, a series of behavioral experimental results revealed that the ovariectomized rats receiving CUS had remarkably elevated anxiety and depression behaviors relative to those in sham group rats, and the sucrose preference rate in the sucrose preference test (SPT) was evidently reduced. In elevated plus maze test (EPM) experiment, the open arm entry time and open arm duration were decreased. In the open field test (OFT), the number of line crossings, rearing number, center square entries, and center square duration were reduced; the grooming time was extended; and the number of fecal particles in rats was increased. In the forced swimming test (FST), the rat immobility rate was increased, while the numbers of swimming and crawling were decreased. Afterwards, we discovered that OVX downregulated the serum levels of estradiol and corticosterone in rats. Thereafter, IF results suggested that OVX dramatically induced the increasing of the number of activated microglial cells in prefrontal cortices and the level of M1-type marker iNOS. Finally, PCR results demonstrated that, compared with the sham group, the proinflammatory and prooxidative genes, such as IL-1β, IL-6, TNF-α, iNOS, and CX3CR1, were upregulated in the prefrontal cortices of OVX rats after CUS stimulation, whereas the anti-inflammatory factor Arg1 and microglial cell negative regulatory factor CD200 were downregulated. To sum up, OVX enhances the CUS-mediated anxiety and depression phenomena in rats, and its mechanism may be related to inducing the activation and polarization of microglial cells in the prefrontal cortex of animal and to accelerating the inflammatory response.
Collapse
|
14
|
Raglan GB, Schulkin J, Micks E. Depression during perimenopause: the role of the obstetrician-gynecologist. Arch Womens Ment Health 2020; 23:1-10. [PMID: 30758732 DOI: 10.1007/s00737-019-0950-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/31/2019] [Indexed: 02/07/2023]
Abstract
Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.
Collapse
Affiliation(s)
- Greta B Raglan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA
| | - Elizabeth Micks
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA.
| |
Collapse
|
15
|
Knight EL, Majd M, Graham-Engeland JE, Smyth JM, Sliwinski MJ, Engeland CG. Gender differences in the link between depressive symptoms and ex vivo inflammatory responses are associated with markers of endotoxemia. Brain Behav Immun Health 2020; 2. [PMID: 34258602 PMCID: PMC8274590 DOI: 10.1016/j.bbih.2019.100013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Depressive symptoms are often linked with higher inflammation and inflammatory responses, although these associations are not always consistent. In a recent study (N = 160, 25–65 years, 67% women), our group reported gender differences relevant to this association: In men higher depressive symptoms were related to heightened ex vivo inflammatory responses to lipopolysaccharide (LPS), whereas in women higher depressive symptoms were related to attenuated inflammatory responses. In the present manuscript, we investigate markers of endotoxemia – i.e., markers of the presence of endotoxin in the blood, presumably due to bacterial translocation from the gut – as factors that elicit gender-dependent immune responses that may be associated with links between depressive symptoms and inflammation. We examined ex vivo inflammatory responses in whole blood via a composite index of LPS-stimulated cytokines. The ratio of LPS-binding protein to soluble CD14 receptor (LBP:sCD14) was quantified as an index of endotoxemia that captures the relative reliance on pro-inflammatory versus non-inflammatory pathways for bacterial clearance. Levels of endotoxemia markers in blood were found to moderate gender differences in the link between depressive symptoms and stimulated inflammation (Gender × Depressive Symptoms × Endotoxemia: B = −0.039, 95%CI [-0.068, 0.009], p = 0.010). At lower LBP:sCD14 levels, depressive symptoms and stimulated inflammation were unrelated in both men and women. However, with higher levels of LBP:sCD14, men showed an increasingly positive correlation and women showed a negative correlation between depressive symptoms and stimulated inflammation. Hence, men and women exhibited similar associations between depressive symptoms and inflammatory responses at lower endotoxin marker levels, but these associations became divergent at higher levels of endotoxin markers. This information provides a novel perspective on risk factors for depression-linked alterations in inflammation, which may help to determine susceptibility to the downstream physical consequences of depressive symptomatology. Depressive symptoms link to higher inflammation in men, lower inflammation in women. These gender differences were only apparent at moderate or higher endotoxemia. Men’s inflammation may be particularly sensitive to depressed mood and endotoxemia. Endotoxemia may be an important factor in gender, depression and inflammation links.
Collapse
Affiliation(s)
- Erik L. Knight
- Center for Healthy Aging, The Pennsylvania State University, USA
- Department of Biobehavioral Health, The Pennsylvania State University, USA
- Corresponding author. 423 Biobehavioral Health, Pennsylvania State University, University Park, PA, 16802, USA.
| | - Marzieh Majd
- Department of Biobehavioral Health, The Pennsylvania State University, USA
| | - Jennifer E. Graham-Engeland
- Center for Healthy Aging, The Pennsylvania State University, USA
- Department of Biobehavioral Health, The Pennsylvania State University, USA
| | - Joshua M. Smyth
- Center for Healthy Aging, The Pennsylvania State University, USA
- Department of Biobehavioral Health, The Pennsylvania State University, USA
- Penn State Milton S. Hershey Medical Center, The Pennsylvania State University, USA
| | - Martin J. Sliwinski
- Center for Healthy Aging, The Pennsylvania State University, USA
- Department of Human Development and Family Studies, The Pennsylvania State University, USA
| | - Christopher G. Engeland
- Center for Healthy Aging, The Pennsylvania State University, USA
- Department of Biobehavioral Health, The Pennsylvania State University, USA
- College of Nursing, The Pennsylvania State University, USA
- Corresponding author. 229 Biobehavioral Health, Pennsylvania State University, University Park, PA, 16802, USA.
| |
Collapse
|
16
|
Sleep-related symptoms of midlife women with and without type 2 diabetes mellitus. ACTA ACUST UNITED AC 2019; 26:1178-1184. [PMID: 31408021 DOI: 10.1097/gme.0000000000001383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the associations between type 2 diabetes mellitus and sleep-related symptoms among midlife women from four major racial/ethnic groups in the United States. METHODS The data from 164 participants of two larger Internet survey studies (62 women diagnosed with type 2 diabetes and 102 women without diabetes) were included. In the original studies, multiple instruments including the questions on background characteristics, health status, and menopause status and the Sleep Index for Midlife Women were used. The data were analyzed using χ tests, independent t tests, Mann-Whitney U tests, and hierarchical multiple regression analyses. RESULTS The mean total number of sleep-related symptoms was significantly higher in those with type 2 diabetes (9.95 ± 5.83) than those without diabetes (7.25 ± 6.08) (t = 2.81, P = 0.006). The mean total severity score of sleep-related symptoms was also significantly higher in those with type 2 diabetes (33.42 ± 22.41) than those without diabetes (21.87 ± 21.40) (t = 3.29, P = 0.001). Among postmenopausal women and Asian women, there were significant differences in total numbers and total severity scores between those with type 2 diabetes and those without diabetes (all P < 0.05). When background characteristics, health status, and menopause status were controlled, having a diagnosis of type 2 diabetes was positively associated with total numbers (β=0.143, P = 0.047) and total severity scores (β=0.176, P = 0.014) of sleep-related symptoms. CONCLUSIONS This secondary analysis supported significant associations of type 2 diabetes to sleep-related symptoms of midlife women from four major racial/ethnic groups in the United States.
Collapse
|
17
|
|
18
|
Assessment of perimenopausal depression: A review. J Affect Disord 2019; 249:216-222. [PMID: 30776662 DOI: 10.1016/j.jad.2019.02.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/04/2019] [Accepted: 02/11/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Within the female life cycle, the perimenopause is considered as a critical period for the development of depression. Prevalence rates are particularly high during this phase. Perimenopausal depression is characterized by affective symptoms as well as menopause-specific somatic complaints. Currently, a variety of questionnaires are used to assess mood during the perimenopause. The aim of this review is to determine the instruments employed to assess perimenopausal depression. METHODS We searched the databases PubMed, Cochrane Library and PsycINFO for human studies investigating perimenopausal depression, and subsequently screened for the assessment instruments used to measure mood and menopause. A total of 37 articles were included. RESULTS Altogether, 14 different instruments were applied to assess mood during menopause. The CES-D was by far the most frequently used depression scale, appearing in 16 out of the 37 studies. The methods used to identify perimenopausal status and symptoms were inconsistent. LIMITATIONS Due to lacking information about data and methodology, a selection bias is conceivable. Additionally, a publication bias is possible. Finally, there is inevitable subjectivity in the screening process of a systematic search. CONCLUSIONS The assessment of depression in the menopausal transition is highly heterogeneous, reducing the overall comparability of study results. Furthermore, menopausal complaints are not sufficiently taken into account. Accordingly, the use of a menopause-specific depression scale is highly recommended in order to account for physical and mood-related symptoms in the menopausal transition.
Collapse
|
19
|
Zhang Y, Zhao X, Leonhart R, Nadig M, Wang J, Zhao Y, Wirsching M, Fritzsche K. A Cross-Cultural Comparison of Climacteric Symptoms, Health-Seeking Behavior, and Attitudes towards Menopause Among Mosuo Women and Han Chinese Women in Yunnan, China. Transcult Psychiatry 2019; 56:287-301. [PMID: 30444458 DOI: 10.1177/1363461518804094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cultural *YZ and XZ contributed equally. background has been shown to influence climacteric symptoms of women. This study compares various characteristics of climacteric symptoms, illness conception, health-seeking behavior, and attitude towards menopause of Mosuo women, a Chinese ethnic minority with a matriarchal structure, and Han Chinese women, the majority ethnic group of China with a patriarchal structure. Through convenience sampling, 51 Mosuo and 47 Han women ages 40 to 60 completed a sociodemographic questionnaire, the modified Kupperman Menopause Index (KMI), the Self-Rating Scale of Illness Conception and Health Seeking Behavior (SSICHSB) and the Menopause Attitude Questionnaire (MAQ). The Mosuo and Han Chinese women are comparable with regard to their age, educational levels and menstrual status. During climacteric, Mosuo women showed less severe melancholia ( p = .009), reported less health-seeking behavior ( p = .009), and displayed more positive attitudes towards menopause than their Han Chinese counterparts ( p < .001). One predictive variable of the melancholia severity in Mosuo was "menarche age", while that in the Han group was "social view on the menopause". Future research with a larger sample is needed to deepen our understanding about the interaction between culture and climacteric symptoms.
Collapse
|
20
|
Balta G, Dalla C, Kokras N. Women's Psychiatry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:225-249. [PMID: 31705497 DOI: 10.1007/978-981-32-9721-0_11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Brain disorders and mental diseases, in particular, are common and considered as a top global health challenge for the twenty-first century. Interestingly, women suffer more frequently from mental disorders than men. Moreover, women may respond to psychotropic drugs differently than men, and, through their lifespan, they endure sex-orientated social stressors. In this chapter, we present how women may differ in the development and manifestation of mental health issues and how they differ from men in pharmacokinetics and pharmacodynamics. We discuss issues in clinical trials regarding women participation, issues in the use of psychotropic medications in pregnancy, and challenges that psychiatry faces as a result of the wider use of contraceptives, of childbearing at older age, and of menopause. Such issues, among others, demand further women-oriented psychiatric research that can improve the care for women during the course of their lives. Indeed, despite all these known sex differences, psychiatry for both men and women patients uses the same approach. Thereby, a modified paradigm for women's psychiatry, which takes into account all these differences, emerges as a necessity, and psychiatric research should take more vigorously into account sex differences.
Collapse
Affiliation(s)
- Georgia Balta
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527, Athens, Greece
| | - Christina Dalla
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527, Athens, Greece
| | - Nikolaos Kokras
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527, Athens, Greece. .,First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| |
Collapse
|
21
|
Bio Psychosocial Risk Factors of Depression in the Menopausal Transition: A Narrative Review. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.12928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
22
|
The challenges of midlife women: themes from the Seattle midlife Women's health study. Womens Midlife Health 2018; 4:8. [PMID: 30766718 PMCID: PMC6298022 DOI: 10.1186/s40695-018-0039-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 05/29/2018] [Indexed: 11/10/2022] Open
Abstract
Background Midlife, the period of the lifespan between younger and older adulthood, has been described as a period of transition in women’s lives. Investigators studying midlife have focused on women 40 to 65 years of age, who typically experience multiple social, psychological and biological challenges, among them the menopausal transition. Investigators have reported a diverse array of stressful events, for example, health concerns, family problems, work-related issues, deaths, frustrated goal attainment, and financial worries; however, none have identified which life events midlife women experience as the most salient. The purpose of this study was to understand the meaning behind the experiences that midlife women identify as the most challenging. Methods Participants were enrolled in The Seattle Midlife Women’s Health Study, a longitudinal study spanning up to 23 years. Summative content analysis, incorporating manifest and latent analysis approaches, was used to identify life experiences that women described as the most challenging looking back over 15 years of being in the study. Eighty-one women responded to the question, “Since you have been in our study (since 1990 or 1991), what has been the most challenging part of life for you?” Results Women identified the most challenging aspects of midlife as changing family relationships, re-balancing work/personal life, re-discovering self, securing enough resources, and coping with multiple co-occurring stressors. Within these themes the most frequently reported challenges were: multiple co-occurring stressors, divorce/breaking up with a partner, health problems of self, and death of parents. Few women mentioned menopause as the most challenging aspect of their lives. Conclusion Women found themselves searching for balance in the midst of multiple co-occurring stressors while coping with losses and transitions, for some in a context of limited resources. Menopause was infrequently mentioned. Future research to identify the challenges experienced by more diverse populations of women and further understanding of the dynamics among multiple co-occurring stressors is needed to provide individualized health care appropriately to midlife women.
Collapse
|
23
|
Muharam R, Setiawan MW, Ikhsan M, Rizkinya HE, Sumapraja K. Depression and its link to other symptoms in menopausal transition. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2017.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
|
24
|
Abstract
OBJECTIVE Anxiety about memory during menopause can affect quality of life. We aimed to improve memory self-efficacy during menopause using a group memory strategies program. METHODS The program was run five times for a total of 32 peri- and postmenopausal women, age between 47 and 60 years, recruited from hospital menopause and gynecology clinics. The 4-week intervention consisted of weekly 2-hour sessions, and covered how memory works, memory changes related to ageing, health and lifestyle factors, and specific memory strategies. Memory contentment (CT), reported frequency of forgetting (FF), use of memory strategies, psychological distress, and attitude toward menopause were measured. A double-baseline design was applied, with outcomes measured on two baseline occasions (1-month prior [T1] and in the first session [T2]), immediately postintervention (T3), and 3-month postintervention (T4). To describe changes in each variable between time points paired sample t tests were conducted. Mixed-effects models comparing the means of random slopes from T2 to T3 with those from T1 to T2 were conducted for each variable to test for treatment effects. RESULTS Examination of the naturalistic changes in outcome measures from T1 to T2 revealed no significant changes (all Ps > 0.05). CT, reported FF, and use of memory strategies improved significantly more from T2 to T3, than from T1 to T2 (all Ps < 0.05). Neither attitude toward menopause nor psychological distress improved significantly more postintervention than during the double-baseline (all Ps > 0.05). Improvements in reported CT and FF were maintained after 3 months. CONCLUSIONS The use of group interventions to improve memory self-efficacy during menopause warrants continued evaluation.
Collapse
|
25
|
Understanding women's experience of memory over the menopausal transition: subjective and objective memory in pre-, peri-, and postmenopausal women. Menopause 2018; 23:1319-1329. [PMID: 27483039 DOI: 10.1097/gme.0000000000000705] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Many women complain of forgetfulness during the menopausal transition. This study aimed to examine women's subjective perception of memory and their objective memory performance across the menopausal transition. METHODS One hundred thirty women, aged 40 to 60 years were recruited from outpatient Menopause and Gynaecological clinics at the Royal Women's Hospital, Melbourne. Women were divided into menopausal stage groups according to the Stages of Reproductive Aging Workshop criteria based on menstrual patterns. All women completed self-report measures of depressive, anxiety, vasomotor, and sleep symptoms; attitude to menopause; and various aspects of memory, including memory contentment, frequency of forgetting, sense of control over memory, and use of memory strategies. Women also completed a comprehensive neuropsychological evaluation assessing memory and executive function. RESULTS Comprehensive neuropsychological assessment showed no difference between premenopausal (n = 36), perimenopausal (n = 54), and postmenopausal (n = 40) groups in performance on memory and executive tasks. Perimenopausal women, however, reported significantly more frequent forgetting (η = 0.09, P < 0.01) and less contentment with their memory (η = 0.08, P < 0.01) than pre- and postmenopausal women. CONCLUSIONS Although no impairment was observed in neuropsychological performance, when compared with pre- and postmenopausal women, perimenopausal women were more likely to be dissatisfied with their memory. During the menopausal transition women with a more negative attitude to menopause and more intense depressive, anxiety, vasomotor, and sleep symptoms are more vulnerable to feeling less content with their memory.
Collapse
|
26
|
Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep 2018; 10:73-95. [PMID: 29445307 PMCID: PMC5810528 DOI: 10.2147/nss.s125807] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years.
Collapse
Affiliation(s)
- Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Melbourne School of Psychological Sciences, University of Melbourne
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University.,Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, VIC, Australia
| |
Collapse
|
27
|
Mitchell ES, Woods NF. Depressed mood during the menopausal transition: is it reproductive aging or is it life? Womens Midlife Health 2017; 3:11. [PMID: 30766711 PMCID: PMC6299984 DOI: 10.1186/s40695-017-0030-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/01/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Although there has been noteworthy attention to both depressed mood symptoms and majordepressive disorder during the menopausal transition (MT), recently investigators have questioned whether there is an over-pathologizing of the MT by emphasizing hormonal effects on depression and deflecting attention from the everyday conditions of women's lives as they relate to depressed mood. In addition, fluctuation of mood over short periods of time may not be captured by measures of depressed mood symptoms such as the CESD, especially when administered using a reference period such as a week or more. The purpose of this study was to examine the association of menopausal transition factors, health-related factors, stress factors, social factors and symptoms with repeated measures of depressed mood reported for a 24 h period. METHODS Seattle Midlife Women's Health Study participants (n = 291, 6977 observations) provided data from 1990 to 2013 including annual questionnaires, symptom diaries and urine specimens assayed for hormones several times per year. Multilevel modeling was used to test bivariate and multivariable models accounting for depressed mood severity. RESULTS In individual models with age as the measure of time, being in early postmenopause, exercising more, and being partnered were associated with less severe depressed mood; greater perceived stress, having a history of sexual abuse, difficulty getting to sleep, early awakening, and awakening at night were each associated with higher depressed mood severity. In a multivariable model (n = 234, 6766 observations), being older, being in the early postmenopause, exercising more, being partnered, were associated with less severe depressed mood; reporting greater perceived stress, history of sexual abuse, difficulty getting to sleep and early awakening were associated with more severe depressed mood. CONCLUSIONS Clinicians need to consider the context in which midlife women experience the menopausal transition and mood symptoms as well as hormonal transitions during this part of the lifespan.
Collapse
Affiliation(s)
| | - Nancy Fugate Woods
- Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, USA
| |
Collapse
|
28
|
Guérin E, Goldfield G, Prud'homme D. Trajectories of mood and stress and relationships with protective factors during the transition to menopause: results using latent class growth modeling in a Canadian cohort. Arch Womens Ment Health 2017; 20:733-745. [PMID: 28707156 DOI: 10.1007/s00737-017-0755-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
The menopause transition is characterized by significant hormonal changes that may predispose women to psychosocial maladjustment. Prospective studies to date have focused primarily on negative mood states and show equivocal findings. The primary goal of this study was to identify patterns of change with respect to positive and negative mood states (vigor, depression, tension, and stress) over a 5-year period in a cohort of women undergoing the transition to menopause. A secondary aim was to determine whether the identified trajectories were associated with menopause status as well as baseline health-related and psychological characteristics. This longitudinal study observed 102 healthy Canadian women who were premenopausal at baseline (age 47-55 years). Analyses consisted of latent class growth modeling. Mood states were predominantly normal and stable, raising doubts regarding the notion that psychosocial distress is a common and natural occurrence during the transition to menopause. Neither time spent in perimenopause nor BMI had a significant influence on levels of mood indicators. However, higher scores on body image, self-esteem, and general health perceptions were predictive of more positive psychological outcomes over the 5-year period. Targeting improvements in self-perceptions may promote a healthier psychological adjustment during this natural transitional period in a women's lifespan.
Collapse
Affiliation(s)
- Eva Guérin
- Institut du Savoir Montfort - Recherche, 202-745A Montréal Rd, Ottawa, ON, K1K 0T1, Canada
| | - Gary Goldfield
- Healthy Active Living and Obesity (HALO) Research group, Children's Hospital of Eastern Ontario (CHEO) Research Institute, 40 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Denis Prud'homme
- Institut du Savoir Montfort - Recherche, 202-745A Montréal Rd, Ottawa, ON, K1K 0T1, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Pr, Ottawa, ON, K1N 1A2, Canada.
| |
Collapse
|
29
|
Perich T, Ussher J, Parton C. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder. BMC WOMENS HEALTH 2017; 17:110. [PMID: 29145856 PMCID: PMC5689207 DOI: 10.1186/s12905-017-0467-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
Background Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Methods Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Results Themes identified included ‘Constructions of mood change: menopause or bipolar disorder?’,‘ Life events, bipolar disorder and menopause coming together’; ‘Treatment choices for mood change during menopause’. Conclusions The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices. Electronic supplementary material The online version of this article (10.1186/s12905-017-0467-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia. .,School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| |
Collapse
|
30
|
Weidner K, Croy I, Siepmann T, Brähler E, Beutel M, Bittner A. Menopausal syndrome limited to hot flushes and sweating a representative survey study. J Psychosom Obstet Gynaecol 2017; 38:170-179. [PMID: 28351196 DOI: 10.1080/0167482x.2017.1291624] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE The menopausal syndrome is described as a series of various physical and nonphysical symptoms attributed to perimenopausal changes in hormone levels. However, evidence is biased by focusing research on the target group of middle aged women only. To overcome this bias, we examined the occurrence of menopausal symptoms during the entire life span in both women and men. METHODS Therefore, we studied the occurrence of menopausal symptoms with the widely used Menopause Rating Scale (MRS) across the entire life span in both women and men. To this end, we performed a nationwide cross-sectional survey study in Germany in which we examined a representative sample of 2527 persons aged from 14 to 95 years. Additionally, sociodemographic factors and self-efficacy were surveyed. RESULTS Although the overall MRS score was generally higher for women compared to men, there was no specific peak for the time of menopause. Instead the score increased linearly with age for both sexes. Furthermore, it was stronger associated with sociodemographic variables and self-efficacy than with the sex of the participants. Among all assessed symptoms, only hot flushes and sweating, but none of the others, emerged as specific for the menopausal episode. CONCLUSIONS Our data indicate that among symptoms commonly classified as menopausal only hot flushes and sweating appear to be specific for the perimenopausal episode. Other symptoms may be caused by a multifactorial etiopathogenesis including physical, sociodemographic, cultural and psychological factors that, in turn, might benefit from multimodal treatment regimes.
Collapse
Affiliation(s)
- Kerstin Weidner
- a Department of Psychotherapy and Psychosomatic Medicine , University hospital C. G. Carus, Technische Universität Dresden , Dresden , Germany
| | - Ilona Croy
- a Department of Psychotherapy and Psychosomatic Medicine , University hospital C. G. Carus, Technische Universität Dresden , Dresden , Germany
| | - Timo Siepmann
- a Department of Psychotherapy and Psychosomatic Medicine , University hospital C. G. Carus, Technische Universität Dresden , Dresden , Germany.,b Department of Neurology , University hospital C. G. Carus, Technische Universität Dresden , Dresden , Germany
| | - Elmar Brähler
- c Department for Psychosomatic Medicine and Psychotherapy , University Medical Center of the Johannes Gutenberg University , Mainz , Germany.,d Department of Medical Psychology and Medical Sociology , University of Leipzig , Leipzig , Germany
| | - Manfred Beutel
- c Department for Psychosomatic Medicine and Psychotherapy , University Medical Center of the Johannes Gutenberg University , Mainz , Germany
| | - Antje Bittner
- a Department of Psychotherapy and Psychosomatic Medicine , University hospital C. G. Carus, Technische Universität Dresden , Dresden , Germany
| |
Collapse
|
31
|
Guérin E, Biagé A, Goldfield G, Prud'homme D. Physical activity and perceptions of stress during the menopause transition: A longitudinal study. J Health Psychol 2017; 24:799-811. [PMID: 28810371 DOI: 10.1177/1359105316683787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The transition to menopause is a critical period of significant biopsychosocial change. The purpose of this study was to examine the influence of the transition to menopause and volume of physical activity on levels of perceived stress over five years in 102 healthy middle-aged women. Questionnaire and accelerometer data were analyzed using linear mixed models. Adjusting for age and body mass index, there were no significant effects of menopause status or time on perceived stress. Independent of menopause status, minutes per week of vigorous activity was associated with lower perceived stress in years 1 and 2 of the study.
Collapse
Affiliation(s)
- Eva Guérin
- 1 Institut de Recherche de l'Hôpital Montfort, Canada
| | - Alyssa Biagé
- 1 Institut de Recherche de l'Hôpital Montfort, Canada.,2 University of Ottawa, Canada
| | - Gary Goldfield
- 3 Children's Hospital of Eastern Ontario (CHEO) Research Institute, Canada
| | - Denis Prud'homme
- 1 Institut de Recherche de l'Hôpital Montfort, Canada.,2 University of Ottawa, Canada
| |
Collapse
|
32
|
Kuehner C. Why is depression more common among women than among men? Lancet Psychiatry 2017; 4:146-158. [PMID: 27856392 DOI: 10.1016/s2215-0366(16)30263-2] [Citation(s) in RCA: 710] [Impact Index Per Article: 101.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/15/2016] [Accepted: 08/15/2016] [Indexed: 02/08/2023]
Abstract
Women are about twice as likely as are men to develop depression during their lifetime. This Series paper summarises evidence regarding the epidemiology on gender differences in prevalence, incidence, and course of depression, and factors possibly explaining the gender gap. Gender-related subtypes of depression are suggested to exist, of which the developmental subtype has the strongest potential to contribute to the gender gap. Limited evidence exists for risk factors to be specifically linked to depression. Future research could profit from a transdiagnostic perspective, permitting the differentiation of specific susceptibilities from those predicting general psychopathologies within and across the internalising and externalising spectra. An integration of the Research Domain Criteria framework will allow examination of gender differences in core psychological functions, within the context of developmental transitions and environmental settings. Monitoring of changing socioeconomic and cultural trends in factors contributing to the gender gap will be important, as well as the influence of these trends on changes in symptom expression across psychopathologies in men and women.
Collapse
Affiliation(s)
- Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| |
Collapse
|
33
|
Hengartner MP. Subtle Scientific Fallacies Undermine the Validity of Neuroendocrinological Research: Do Not Draw Premature Conclusions on the Role of Female Sex Hormones. Front Behav Neurosci 2017; 11:3. [PMID: 28144217 PMCID: PMC5239782 DOI: 10.3389/fnbeh.2017.00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/05/2017] [Indexed: 11/13/2022] Open
Abstract
Major scientific flaws such as reporting and publication biases are well documented, even though acknowledgment of their importance appears to be lacking in various psychological and medical fields. Subtle and less obvious biases including selective reviews of the literature and empirically unsupported conclusions and recommendations have received even less attention. Using the literature on the association between transition to menopause, hormones and the onset of depression as a guiding example, I outline how such scientific fallacies undermine the validity of neuroendocrinological research. It is shown that in contrast to prominent claims, first, most prospective studies do not support the notion that the menopausal transition relates to increased risk for depression, second, that associations between hormone levels and depression are largely inconsistent and irreproducible, and, third, that the evidence for the efficacy of hormone therapy for the treatment of depression is very weak and at best inconclusive. I conclude that a direct and uniform association between female sex hormones and depression is clearly not supported by the literature and that more attention should be paid to the manifold scientific biases that undermine the validity of findings in psychological and medical research, with a specific focus on the behavioral neurosciences.
Collapse
Affiliation(s)
- Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW) Zurich, Switzerland
| |
Collapse
|
34
|
Masoumi SZ, Kazemi F, Tavakolian S, Rahimi A, Oshvandi K, Soltanian A, Shobeiri F. Effect of Citalopram in Combination with Omega-3 on Depression in Post-menopausal Women: A Triple Blind Randomized Controlled Trial. J Clin Diagn Res 2016; 10:QC01-QC05. [PMID: 27891399 DOI: 10.7860/jcdr/2016/19487.8597] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Depressive disorder is a common and disabling disorder that causes high rates of morbidity and mortality. Citalopram is an antidepressant drug, of the Selective Serotonin Reuptake Inhibitor (SSRI) class that has been used for geriatric depression since a long time ago. Prescription of omega-3 in geriatric depression has been increased recently; because of more favorable profile of their side effects. Some of the studies reported that omega-3 is effective in prevention or treatment of depressive disorders than Citalopram. However, there are contradictory studies too. AIM This study aimed to investigate the effect of a combination of omega-3 and citalopram in the treatment of women with post-menopausal depression. MATERIALS AND METHODS This triple-blind randomized controlled trial was conducted on 60 women with post-menopausal depression who were referred to the Hamadan Fatemieh Hospital. After the participants completed the DSM-IV questionnaire and depression was confirmed by a psychiatrist, participants were assigned randomly into two-intervention and control groups. The patients in the control group received 20mg citalopram along with a placebo while patients in the intervention group received 20mg citalopram and 1g of omega-3. At baseline and at the end of the first, second, and fourth weeks, all of the participants answered the Beck's Depression Inventory (BDI). Descriptive statistics and t-test, repeated measures analysis of variance and Bonferroni post-hoc test was used to analyse the data. RESULTS The depression score was 6.1±2.41 in intervention and 25.22±10.04 in control group, four weeks after intervention. A decreasing trend was observed in the mean depression scores of the intervention group during the study. Using repeated measures analysis of variance, a significant difference was observed between the mean depression scores of the two groups at the four measurement time-points (p<0.001). The mean depression scores of the intervention group were significantly lower than the control group either two weeks (p< 0.001) or four weeks after the treatments (p< 0.001). CONCLUSION Using omega-3, can reduce the severity of depression in post-menopausal women.
Collapse
Affiliation(s)
- Seyedeh Zahra Masoumi
- PhD, Department of Midwifery, Research Center for Child and Maternity Care, School of Nursing and Midwifery, Hamadan University of Medical Sciences , Hamadan, Iran
| | - Farideh Kazemi
- PhD Student of Reproductive Health, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Samira Tavakolian
- Msc, Midwife in Fatemieh Hospital, Hamadan University of Medical Sciences , Iran
| | - Alireza Rahimi
- Faculty, Department of Psychiatry, Research Center for Behavioural Disorders and Substance Abuse, Hamadan University of Medical Sciences , Hamadan, Iran
| | - Khodayar Oshvandi
- PhD, Department of Medical_Surgical Nursing, Research Center for Child and Maternity Care, School of Nursing and Midwifery, Hamadan University of Medical Sciences , Hamadan, Iran
| | - Alireza Soltanian
- PhD, Department of Biostatistics and Modelling of Noncomunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences , Hamadan, Iran
| | - Fatemeh Shobeiri
- PhD, Department of Midwifery, Research Center for Child and Maternity Care, School of Nursing and Midwifery, Hamadan University of Medical Sciences , Hamadan, Iran
| |
Collapse
|
35
|
|
36
|
Rössler W, Ajdacic-Gross V, Riecher-Rössler A, Angst J, Hengartner MP. Does menopausal transition really influence mental health? Findings from the prospective long-term Zurich study. World Psychiatry 2016; 15:146-54. [PMID: 27265705 PMCID: PMC4911775 DOI: 10.1002/wps.20319] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
In the prospective long-term Zurich study, we re-examined the hypothesized association between mental health problems in women and the transition through menopausal stages. One hundred sixty-eight women from a population-based Swiss community cohort were prospectively followed up from age 21 to 50. At age 50, the occurrence of hot flushes/night sweats and sleep disturbances was significantly more frequent in peri- and post-menopausal women. Irritability/nervousness was increased only in peri-menopausal women, but that association was accounted for by neuroticism trait scores at age 30. Transitions to peri- or post-menopause were not related to changes in either the prevalence rates of DSM major depressive episode or anxiety disorders, or the course of psychopathological syndromes as assessed by the Symptom Checklist 90 - Revised. The null associations held when adjusting for duration of reproductive period or age at menopause. Preceding mental health problems between ages 21 and 41, increased neuroticism trait scores at age 30, and concurrent psychosocial distress were significantly related to mental health problems occurring between ages 41 and 50. Depending upon the cut-off point that was chosen, the arbitrary dichotomization of a continuous depression outcome produced spurious associations with the menopausal transition. We conclude that mental health problems between ages 41 and 50 are probably not directly related to the menopausal transition, and that previously reported associations could be false positives due to inadequate dichotomizations, reporting bias, undisclosed multiple adjustments or overfitting.
Collapse
Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of São Paulo, Brazil
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Clinics, Center for Gender Research and Early Detection, Basel, Switzerland
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| |
Collapse
|
37
|
The relationships between psychological symptoms and cardiovascular symptoms experienced during the menopausal transition: racial/ethnic differences. Menopause 2015; 23:396-402. [PMID: 26645821 DOI: 10.1097/gme.0000000000000545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of the study was to examine the relationships between psychological and cardiovascular symptoms in a multiethnic group of midlife women while controlling for other influencing factors, and to determine the association of race/ethnicity to the relationships between psychological and cardiovascular symptoms. METHODS This was a secondary analysis of the data among 1,054 midlife women from two Internet surveys. The instruments included the questions on background characteristics, health, and menopause status and the Midlife Women's Symptom Index. The data were analyzed using correlation analyses, chi-squared tests, analysis of variance, and multivariate linear and logistic regression analyses. RESULTS The total numbers and total severity scores of psychological symptoms were significantly related to those of cardiovascular symptoms as a whole and in each racial/ethnic group (P < 0.01). In total participants, both the total numbers and total severity scores of psychological symptoms were significantly associated with increased risk for cardiovascular symptoms after adjusting for race/ethnicity (P < 0.01), and there were no interactions between race/ethnicity and psychological symptoms. The existence of diagnosed cardiovascular diseases was significantly associated with the total numbers of and total severity scores of psychological symptoms only in Asian women. CONCLUSIONS Further studies on the mechanisms through which psychological symptoms are related to cardiovascular symptoms are needed while controlling for race/ethnicity.
Collapse
|
38
|
Arroll N, Armstrong S, Aneke KU, Jordan V, Farquhar C. Decision aids for the management of menopausal symptoms. Hippokratia 2015. [DOI: 10.1002/14651858.cd011892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Nicola Arroll
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| | - Sarah Armstrong
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| | | | - Vanessa Jordan
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| | - Cindy Farquhar
- University of Auckland; Department of Obstetrics and Gynaecology; Private Bag 92019 Grafton Auckland New Zealand 1142
| |
Collapse
|
39
|
Freeman EW. Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population. Womens Midlife Health 2015; 1:2. [PMID: 30766689 PMCID: PMC6214217 DOI: 10.1186/s40695-015-0002-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/18/2015] [Indexed: 01/05/2023] Open
Abstract
There is accumulating evidence but no definitive answers about the incidence of depressed mood in the menopause transition and its association with the changing hormonal milieu. While a changing hormonal milieu is the natural condition for all women, only a minority of mid-life women experience debilitating depressive symptoms or clinical depression. This review focuses on associations between depressed mood and the menopause transition, primarily as identified in longitudinal, population-based studies in the past decade. Further aims were to present reported associations between depressed mood and reproductive hormones in the menopause transition as evaluated in the general population and associations of depressive symptoms or clinical depression with menopausal hot flashes or poor sleep in perimenopausal women. There is evidence to support the role of the changing endocrine milieu in the development of depressed mood in the menopause transition, but the contribution of hormones as measured is small. Disentangling the numerous factors that are associated with depression in midlife women is a major challenge for research and for clinical care, where treatments are needed to improve the most distressing menopausal symptoms.
Collapse
Affiliation(s)
- Ellen W. Freeman
- Department of Obstetrics/Gynecology and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3701 Market Street, Suite 820 (Mudd Suite), Philadelphia, PA 19104 USA
| |
Collapse
|
40
|
Campbell KE, Szoeke CE, Dennerstein L. The course of depressive symptoms during the postmenopause: a review. Womens Midlife Health 2015; 1:3. [PMID: 30766690 PMCID: PMC6214214 DOI: 10.1186/s40695-015-0003-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 06/19/2015] [Indexed: 11/10/2022] Open
Abstract
As the Australian population ages, significantly more women are entering the postmenopausal stage of the climacteric, yet research focusing on the prevalence of depressive symptoms in this stage of ovarian ageing is scarce. This review will examine the information provided by studies that have a cohort with data of adequate duration to explore depressive symptom prevalence in the early and late postmenopause. Longitudinal epidemiological studies of women transitioning through the postmenopause that included measures of mood and/or depressive symptoms were identified through searches of MEDLINE (1980-2014) and PsycINFO (1980-2014) databases. Population based studies with at least two time points of assessment were included. Longitudinal studies of ageing that did not categorise women as postmenopausal were not included, as this was outside the scope of this review. Prevalence estimates of depressive symptoms varied between studies and ranged from 8.5 % to 25.7 % with percentages between 22 and 25 % being most consistently reported. Surgical postmenopause groups reported higher ratings of depressive symptoms at 18-42 % and higher incidence of major depressive disorder in all but one study. The prevalence of Major Depressive Disorder also varied with ranges from <1 % to 42 % reported. Wide ranges in prevalence were reported in the literature. Differences in definitions, inconsistent sample sizes and varying measures make it difficult to compare results across studies. The specific inclusions and exclusions of sub-samples of larger cohorts are at times inconsistent with epidemiological acquisition and, as such, impact upon generalizability of results to a healthy population.
Collapse
|
41
|
Borkoles E, Reynolds N, Thompson DR, Ski CF, Stojanovska L, Polman RC. The role of depressive symptomatology in peri- and post-menopause. Maturitas 2015; 81:306-10. [DOI: 10.1016/j.maturitas.2015.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
|
42
|
Brown L, Bryant C, Brown V, Bei B, Judd F. Investigating how menopausal factors and self-compassion shape well-being: An exploratory path analysis. Maturitas 2015; 81:293-9. [DOI: 10.1016/j.maturitas.2015.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/01/2015] [Accepted: 03/02/2015] [Indexed: 11/16/2022]
|
43
|
Im EO, Ham OK, Chee E, Chee W. Physical activity and depressive symptoms in four ethnic groups of midlife women. West J Nurs Res 2015; 37:746-66. [PMID: 24879749 PMCID: PMC4344416 DOI: 10.1177/0193945914537123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to determine the associations between physical activity and depression and the multiple contextual factors influencing these associations in four major ethnic groups of midlife women in the United States. This was a secondary analysis of the data from 542 midlife women. The instruments included questions on background characteristics and health and menopausal status; the Depression Index for Midlife Women (DIMW); and the Kaiser Physical Activity Survey (KPAS). The data were analyzed using chi-square tests, the ANOVA, two-way ANOVA, correlation analyses, and hierarchical multiple regression analyses. The women's depressive symptoms were negatively correlated with active living and sports/exercise physical activities whereas they were positively correlated with occupational physical activities (p < .01). Family income was the strongest predictor of their depressive symptoms. Increasing physical activity may improve midlife women's depressive symptoms, but the types of physical activity and multiple contextual factors need to be considered in intervention development.
Collapse
Affiliation(s)
- Eun-Ok Im
- University of Pennsylvania, Philadelphia, USA
| | | | - Eunice Chee
- University of Pennsylvania, Philadelphia, USA
| | | |
Collapse
|
44
|
Brown L, Bryant C, Judd FK. Positive well-being during the menopausal transition: a systematic review. Climacteric 2015; 18:456-69. [DOI: 10.3109/13697137.2014.989827] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
45
|
Quattrocchi T, Micali E, Gentile A, La Ferrera EG, Barbaro L, Ciarcià S, Corrado F, Di Costa M, Fazio R, Licenziato R, Marcazzò A, Minniti R, Riccobene R, Russello CM, Cancellieri F. Effects of a phyto complex on well-being of climacteric women. J Obstet Gynaecol Res 2015; 41:1093-8. [PMID: 25656636 DOI: 10.1111/jog.12659] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 11/05/2014] [Indexed: 01/06/2023]
Abstract
AIM The aim of this study was to assess the effects of a phyto complex on menopausal symptoms. MATERIAL AND METHODS A total of 151 women aged 42-67 years were enrolled. They were in spontaneous or surgical menopause by at least 12 months, reporting symptoms referable to the climacteric syndrome. Two validated and standardized tests were given to the whole sample at the entrance of the study (T0) and after 6 months of treatment (T6): the Greene Climacteric Scale (GCS) and the Beck Depression Inventory (BDI). Interim evaluations were carried out at 1-3 months (T1 and T3) on five symptoms selected from the GCS. The phyto complex was given to each enrolled woman, from the T0 to T6 time-points, for a total of 180 days. RESULTS At the T0 time-point, the average scores were: GCS, 28.98 (standard deviation [SD] ± 10.71); BDI, 14.48 (SD ± 6.5). At the T1 time-point, five parameters of the GCS were assessed with a reduction of 36.25% in symptoms (5.69, SD ± 3.53). At the T6 time-point the assessment was completed: average GCS results were 11.54 (SD ± 8.01) with a 60.17% improvement; and average BDI results were 6.11 (SD ± 4.6) with a 58.91% improvement in the depressive symptoms. CONCLUSIONS The phyto complex under consideration is an effective tool to counter, in a quick and long-lasting manner, the most common and nagging symptoms of the climacteric syndrome, such as hot flushes, insomnia and depression.
Collapse
Affiliation(s)
- Tomasella Quattrocchi
- Department of Paediatric, Gynaecological, Microbiological and Biomedical Sciences, University of Messina, Messina, Italy
| | - Elvira Micali
- Prevention and Protection, University of Messina, Messina, Italy
| | | | | | | | | | - Francesco Corrado
- Department of Paediatric, Gynaecological, Microbiological and Biomedical Sciences, University of Messina, Messina, Italy
| | - Maria Di Costa
- Obstetrics and Gynaecology Hospital, C. Basilotta Hospital, Enna, Italy
| | - Roberto Fazio
- Obstetrics and Gynaecology Operating Unit Barcellona P.G. - Via Salvatore Cattafi, Messina, Italy
| | | | | | | | | | | | - Francesco Cancellieri
- Department of Paediatric, Gynaecological, Microbiological and Biomedical Sciences, University of Messina, Messina, Italy
| |
Collapse
|
46
|
|
47
|
Im EO, Rendell Endowed MO, Chang SJ, Chee W, Chee E, Mao J. Immigration transition and depressive symptoms: four major ethnic groups of midlife women in the United States. Health Care Women Int 2014; 36:439-56. [PMID: 24875592 PMCID: PMC4525474 DOI: 10.1080/07399332.2014.924518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to explore the relationships between immigration transition and depressive symptoms among 1,054 midlife women in the United States. This was a secondary analysis of the data from two national Internet survey studies. Questions on background characteristics and immigration transition and the Depression Index for Midlife Women were used to collect the data. The data were analyzed using inferential statistics including multiple regressions. Immigrants reported lower numbers of symptoms and less severe symptoms than nonimmigrants (p <.01). When controlling for background characteristics, self-reported racial/ethnic identity and immigration status were significant predictors of depressive symptoms (R(2) =.01, p <.05).
Collapse
Affiliation(s)
- Eun-Ok Im
- University of Pennsylvania, School of Nursing, 418 Curie Blvd. Philadelphia, PA 19104
| | | | - Sun Ju Chang
- University of Pennsylvania, School of Nursing, 418 Curie Blvd. Philadelphia, PA 19104
| | - Wonshik Chee
- University of Pennsylvania, School of Nursing, 418 Curie Blvd. Philadelphia, PA 19104
| | - Eunice Chee
- University of Pennsylvania, School of Engineering and Applied Science, 220 S 33rd St Philadelphia, PA 19104
| | - Jun Mao
- University of Pennsylvania, School of Medicine, 3600 Market Street, Suite 240 Philadelphia PA 19104-2646
| |
Collapse
|
48
|
Bryant C, Kleinstäuber M, Judd F. Asptects of mental health care in the gynecological setting. WOMENS HEALTH 2014; 10:237-54. [PMID: 24956291 DOI: 10.2217/whe.14.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Psychological disorders are commonly associated with gynecological conditions, but are frequently undetected and untreated, and may influence the presentation and treatment outcomes of the physical condition. A literature search was conducted in order to provide a narrative review of psychological aspects of menopause, premenstrual syndrome, premenstrual dysphoric disorder, chronic pelvic pain, incontinence and polycystic ovarian syndrome. All the conditions that have been addressed in this review can be associated with an increased risk of psychological symptoms and disorders. Anxiety and depression are common and are associated with significant morbidity. Gynecological conditions, by their nature, are likely to be accompanied by impairments in social, occupational and personal functioning. Greater emphasis should be placed on the mental health aspects of gynecological conditions.
Collapse
Affiliation(s)
- Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria 3010 Australia
| | | | | |
Collapse
|
49
|
Vivian-Taylor J, Hickey M. Menopause and depression: is there a link? Maturitas 2014; 79:142-6. [PMID: 24951102 DOI: 10.1016/j.maturitas.2014.05.014] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 01/22/2023]
Abstract
AIM Depression is common and may have significant implications for the individual, their families and work and for the health care system. The menopause transition (MT) may be an 'at risk' time for the development of depression. This review aims to explore the relationship between depression and MT and the complex interaction between the biological, psychological and social factors that inform it. METHODS The literature on depressive disorders and MT is reviewed. RESULTS AND CONCLUSIONS Longitudinal studies have demonstrated an association between the menopause transition (MT) and an increase in depressive symptoms. A trend towards higher rates of depressive disorders during the MT, has also been shown, although not always reaching statistical significance. Risk factors for the development of depressive symptoms and depression in the MT include the presence of vasomotor symptoms (VMS), a personal history of depression (particularly depression that is related to pregnancy or hormonal changes through the menstrual cycle), surgical menopause, adverse life events, and negative attitudes to menopause and ageing. A treatment approach to depression during the MT exploits the biological as well as the psychosocial factors that are likely to be contributing in an individual.
Collapse
Affiliation(s)
| | - Martha Hickey
- Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; The Royal Women's Hospital, Melbourne, Victoria, Australia.
| |
Collapse
|
50
|
Montesó-Curto P, Ferré-Grau C, Lleixà-Fortuño M, Albacar-Riobóo N, Lejeune M. Diagnosed, identified, current and complete depression among patients attending primary care in southern Catalonia: different aspects of the same concept. Arch Psychiatr Nurs 2014; 28:50-4. [PMID: 24506987 DOI: 10.1016/j.apnu.2013.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 09/14/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
Abstract
The aims of this study were to explore the prevalence and the conceptualizations of depression detected by the healthcare system, identified by the patient or classified/identified in the validated Goldberg's questionnaire in a community. We conducted a cross-sectional evaluation of 317 patients. The different types of depression diagnosed, identified, current or total were stratified by age and gender groups. The difference in the conceptualization of depression from the medical or ordinary people point of view indicate that depression care requires the understanding of the lifestyle, beliefs, attitudes, family and social networks of the people the physicians and nurses care for.
Collapse
Affiliation(s)
| | - Carme Ferré-Grau
- Department of Nursing. Rovira i Virgili University, Tarragona, Spain
| | | | | | - Marylene Lejeune
- Molecular Biology and Research Section, Hospital de Tortosa Verge de la Cinta, IISPV, URV, Tortosa, Spain
| |
Collapse
|